Clinical effectiveness of MARS treatment - multidirectional analysis of positive clinical response to treatment.
MARS therapy
albumin dialysis
liver failure
liver support system
Journal
Clinical and experimental hepatology
ISSN: 2392-1099
Titre abrégé: Clin Exp Hepatol
Pays: Poland
ID NLM: 101703431
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
20
03
2019
accepted:
11
06
2019
entrez:
2
1
2020
pubmed:
2
1
2020
medline:
2
1
2020
Statut:
ppublish
Résumé
Liver failure is a life-threatening condition which often requires intensive care treatment. It is essential to quickly determine whether there are indications for extracorporeal liver support systems for the patient. The aims of the study were: to assess effectiveness of molecular adsorbent recirculating system (MARS) therapy based on selected clinical criteria, to analyze the moment of clinical response and to create a patient's profile, who will benefit clinically from the treatment. The analysis encompassed medical histories of 65 patients treated with MARS. Effectiveness of treatment was evaluated based on selected clinical parameters. Statistical analysis was performed based on medical data gathered. There were 158 cycles of MARS performed, with effectiveness documented in 57 cycles (36.6%). The first MARS session was effective in 43.1% of patients. They also more often responded to the second cycle (63.6% vs. 15.4%). A significant part of the analysis was devoted to create a profile of the patient in whom positive response can be expected. A low MELD score and low baseline white blood cells (WBC) level are statistically significant factors in multivariate analysis of selected features of positive clinical response to treatment. MARS therapy is an effective form of treatment in a properly selected group of patients with liver failure. The first MARS session is the most effective one. It is also a good prognostic factor for further clinical response to treatment. Multifactorial analysis of positive clinical response to treatment enables to create a patient's profile based on the lower baseline MELD score and WBC.
Identifiants
pubmed: 31893237
doi: 10.5114/ceh.2019.89163
pii: 38370
pmc: PMC6935846
doi:
Types de publication
Journal Article
Langues
eng
Pagination
271-278Informations de copyright
Copyright: © 2019 Clinical and Experimental Hepatology.
Déclaration de conflit d'intérêts
The authors report no conflict of interest.
Références
Gastroenterology. 2013 Jun;144(7):1426-37, 1437.e1-9
pubmed: 23474284
Crit Care. 2006;10(4):R108
pubmed: 16859530
Hepatology. 2014 Aug;60(2):715-35
pubmed: 25042402
Gastroenterology. 1989 Aug;97(2):439-45
pubmed: 2490426
Crit Care Med. 1985 Oct;13(10):818-29
pubmed: 3928249
J Hepatol. 2012 Dec;57(6):1336-48
pubmed: 22750750
Liver Transpl. 2007 Jun;13(6):814-21
pubmed: 17370333
Br J Surg. 1973 Aug;60(8):646-9
pubmed: 4541913
J Am Soc Nephrol. 2001 Feb;12 Suppl 17:S75-82
pubmed: 11251037
Intensive Care Med. 1996 Jul;22(7):707-10
pubmed: 8844239
World J Gastroenterol. 2009 Jun 28;15(24):3015-24
pubmed: 19554655
Hepatology. 2001 Feb;33(2):464-70
pubmed: 11172350
Pediatr Nephrol. 2013 Jun;28(6):983-6
pubmed: 23471476
Hepatology. 2012 Mar;55(3):965-7
pubmed: 22213561
Am J Gastroenterol. 2001 Apr;96(4):1217-23
pubmed: 11316173
Hepatology. 1986 Jul-Aug;6(4):648-51
pubmed: 3732998
J Hepatol. 2010 Aug;53(2):307-12
pubmed: 20580987
ASAIO J. 2012 Jan-Feb;58(1):51-9
pubmed: 22210651
Ann Hepatol. 2011 May;10 Suppl 1:S21-8
pubmed: 21566251
Ann Intern Med. 2002 Dec 17;137(12):947-54
pubmed: 12484709
Liver Transpl. 2000 May;6(3):277-86
pubmed: 10827226
Int J Artif Organs. 1996 Nov;19(11):677-91
pubmed: 8970836
Can J Gastroenterol. 2012 Nov;26(11):799-805
pubmed: 23166903
Artif Organs. 2017 Sep;41(9):818-826
pubmed: 28337775
Aliment Pharmacol Ther. 2006 Feb 1;23(3):351-63
pubmed: 16422994
Blood Purif. 2017;44(2):129-139
pubmed: 28571019
JAMA. 1993 Dec 22-29;270(24):2957-63
pubmed: 8254858
Metab Brain Dis. 2008 Dec;23(4):387-98
pubmed: 18773287